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See a sample rate comparisonHCPCS L2128 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Knee ankle foot orthosis(KAFO), fracture orthosis, femoral fracture cast orthosis, custom-fabricated
| Key Fact | Detail |
|---|---|
| Service Type | Orthotic Procedures and services Knee-ankle-foot Orthotics |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for L2128 |
National average reimbursement for HCPCS L2128 by major payers:
$1,888.52
$1,143.10
$1,196.31
$2,284.86
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HCPCS L2128
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$4,711.70Published rateThe Baxley And Appling County Hospital Authority, Appling Healthcare System
Appling Hospital
$1,290.77Published rateBama Heart Doc, P.C., Alabama Heart And Vascular Medicine
Bama Heart Doc, PC Dba Alabama Heart & Vascular Medicine
$963.76Published rateEvans Memorial Hospital, Inc.
Evans Memorial Hospital Inc
$923.53Published rateTy Cobb Healthcare System, Cobb Memorial Hospital
Community Services Group Inc
$839.00Published rate
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See a sample payer proposalHCPCS L2128 vs. Other Knee-ankle-foot Orthotics Codes
The HCPCS L2128 code is part of the Orthotic Procedures and services services used for Knee-ankle-foot Orthotics. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS L2128 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| L2126-HCPCS | High | Knee ankle foot orthosis (KAFO), fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom-fabricated |
| L2128-HCPCS | High | Knee ankle foot orthosis(KAFO), fracture orthosis, femoral fracture cast orthosis, custom-fabricated |
| L2132-HCPCS | Moderate | Knee ankle foot orthosis(KAFO), fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS L2128. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the L2128 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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